Provider Demographics
NPI:1811955131
Name:SOUTHWEST HEMATOLOGY ONCOLOGY PC
Entity type:Organization
Organization Name:SOUTHWEST HEMATOLOGY ONCOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DORIAN
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-494-6800
Mailing Address - Street 1:11209 N TATUM BLVD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3091
Mailing Address - Country:US
Mailing Address - Phone:602-494-6868
Mailing Address - Fax:602-494-6869
Practice Address - Street 1:11209 N TATUM BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3091
Practice Address - Country:US
Practice Address - Phone:602-494-6800
Practice Address - Fax:602-494-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ77077Medicare PIN